The reconstructive ladder. An orthoplastic approach.

The reconstructive ladder has many rungs. The reconstructive surgeon may go from one level to another and, in many instances, simultaneously employ different aspects of the ladder for different problems (i.e., a free-muscle transplant to a large lower extremity defect being covered by split-thickness skin grafts uses two rungs on the ladder). Familiarly with local as well as distant tissue options ensures success when the soft-tissue envelope is treated using this reconstructive ladder.